European Food Safety agency EFSA has traced the food chains from the seed sprout associated E. coli food illness in the EU that has killed 48 people. The evidence is pointing to imported Egyptian fenugreek seeds at this moment in the investigation. CIDRAP provide a good commentary on this, reposted here**.

The problem may be invalid seed sanitisation and seed supplier auditing. If this common source of contamination is confirmed, it would demonstrate that all of the following are true:1) Organic* seed sanitisation procedures at the farm linked to the German outbreak are faulty and unsafe.2) Quality and safety standards for seed supplies used at the same organic farm are inadequate.and3) Legal standards for farm food safety compliance in Germany are faulty.

Lisa Schnirring Staff WriterJun 29, 2011 (CIDRAP News) – New trace-back investigations in German and French Escherichia coli outbreaks are pointing to two lots of fenugreek seeds that were imported from Egypt, according to the latest threat assessment from European officials.Sprouts from Egyptian fenugreek seeds are suspected in both a cluster of French E coli O104:H4 illnesses and the large outbreak in Germany involving the same strain, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) said in a risk assessment today. But the agencies cautioned that there is no lab evidence yet tying the seeds to the outbreaks.

The ECDC and the EFSA said they have urgently requested that the German-based company that imported the seeds help them track other customers who received fenugreek seeds from the two lots.

Officials suspect that Egyptian fenugreek seeds imported in 2009 are linked to the French E coli cluster and that a batch from 2010 is linked to the German outbreak. The ECDC identified the seed importer as AGA SAAT GMBH, based in Dusseldorf, Germany. It said a UK company that reportedly supplied the sprout seeds linked to the French cluster obtained the seeds from AGA SAAT GMBH.

So far investigators have not found a sprout connection to a Swedish E coli O104:H4 case reported yesterday, but the investigation is ongoing, the ECDC said. The patient, a man from southern Sweden, does not have a travel history to Germany and does not recall eating sprouts. Food safety experts have cautioned that sprout consumption can be hard to trace, because the item often appears inconspicuously in salads, sandwiches, and garnishes.

Warnings about sprout consumption should cover all sprouts, because seeds sold for sprouting are often sold as mixes, and cross-contamination could occur during repackaging, the ECDC said. The ECDC and the EFSA are urging consumers not to grow their own sprouts and to avoid eating sprouts unless they have been thoroughly cooked.

If the link between the French cluster and the German outbreak is confirmed, more E coli O104:H4 cases are expected in Europe, along with other countries that received the contaminated seeds, the ECDC warned. It urged clinicians to be on alert to quickly identify new E coli infections that might be part of clusters or the outbreak.

Sprouting fenugreek seeds by Death by Boker, via Flickr

In the French cluster, 15 cases of bloody diarrhea have been identified so far, and 11 of the patients attended the same Jun 8 event where sprouts were served. Eight developed hemolytic uremic syndrome (HUS), a potentially fatal kidney complication. Leftover seeds are being tested.

The ECDC said it has received reports of 32 more E coli infections, raising Europe’s outbreak total to 4,055. No new HUS cases or deaths were reported, keeping those totals at 885 and 48, respectively,

Key quotes from that report:http://ecdc.europa.eu/en/publications/Publications/2011June29_RA_JOINT_EFSA_STEC_France.pdfFood traceback Investigations at the EU levelThe consumption of sprouts is the suspected vehicle of infection in both the French cluster and the German outbreak, and the isolated E. coli O104:H4 strain in human cases in both countries is the same, indicating a potential link between these two public health events. Therefore, it is opportune to strengthen trace-back and trace-forward investigations at national and EU level to identify what commonalities exist between the sprout production chains (distributor chains, distributors, retail outlets and suppliers) in Germany and France, and to identify any potentially contaminated batches of sprout seeds, so as to implement recall notifications in order to remove the vehicle of transmission quickly. Such traceback investigations require close collaboration between national level, EU level and international public health and food safety institutions. They are currently being coordinated by the European Food Safety Authority (EFSA) taskforce established for this purpose, following a request from the European Commission.

The tracing back is progressing and has thus far shown that fenugreek seeds imported from Egypt either in 2009 and/or 2010 are implicated in both outbreaks. There is still much uncertainty about whether this is truly the common cause of all the infections as there are currently no positive bacteriological results. In particular, the 2009 lot appears to be implicated in the outbreak in France and the 2010 has been considered to be implicated in the German outbreak.

Furthermore, this link does not explain the most recent case in Sweden, currently under investigation and in which, thus far, no consumption of sprouts has been implicated.

All this is being further investigated. In particular, an investigation on the distribution of seeds from these lots throughout Germany and Europe has been urg
ently requested. The export of some of the seeds imported from Egypt to another company in the UK (from where seeds were exported to France) demonstrates the necessity of this information.

It is also noted that seeds sold for sprouting are often sold as seed mixes and that during re-packaging crosscontamination can not be excluded. Therefore, any advice to consumers should at this time cover all seeds and raw sprouts derived thereof.

As the death toll in the German E. coli O104 sprout outbreak rose to 50 with 4,121 ill including 845 with hemolytic uremic syndrome, Egypt’s ministry of agriculture said, don’t blame Egypt.The head of Egypt’s Central Administration of Agricultural Quarantine, Ali Suleiman, said claims by the European Food Safety Authority (EFSA) that Egyptian fenugreek seeds exported in 2009 and 2010 may have been implicated in the outbreak were “completely untrue.”

“The presence of this bacteria in Egypt has not been proven at all, and it has not been recorded. He said the Egyptian company that exported the seeds in 2009 has stressed in a letter that it had exported the fenugreek to Holland and not to Germany, Britain or France.

On Wednesday, the EFSA said a “rapid risk assessment” it conducted with the European Centre for Disease Prevention and Control (ECDC), had shown the Egyptian seeds could have been to blame.Meanwhile, the U.K. Food Standards Agency reiterated its advice that sprouted seeds should not be eaten raw, while Bloomberg reports that crudités – fancy French word for raw vegetables — eaten at a children’s center in Bordeaux are helping doctors in their two-month hunt for the source of the outbreak.Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said, “Fenugreek is showing up clearly in the French outbreak and showing up clearly in the German outbreak.”The link to fenugreek, a clover-like plant used as both an herb and a spice, was identified after disease investigators found it was served at an event attended by patients in the Bordeaux suburb of Begles.A cold buffet was served consisting of crudites, or raw vegetables, three dips, industrially produced gazpacho, a choice of two cold soups, pasteurized fruit juices and individual dishes composed of white grapes, tomatoes, sesame seeds, chives, industrially produced soft cheese and fruit, the report said.The soups were served with fenugreek sprouts, a small amount of which were also placed on the crudite dishes. Mustard and rocket sprouts, still growing on cotton wool, were used to decorate the dishes, the authors said.The sprouts had been grown from rocket, mustard and fenugreek seeds planted at the center the previous week. The seeds were bought from a branch of a national chain of gardening retailers, having been supplied by a distributor in the U.K., the authors said.The European agencies advised consumers not to grow sprouts for their own use or to eat sprouts or sprouted seeds unless they have been thoroughly cooked.http://www.sacbee.com/2011/07/01/3740963/ecoli-death-toll-increases-to.htmlhttp://en.news.maktoob.com/20090000852116/Egypt_denies_its_seeds_caused_E_coli_outbreak/Article.htmhttp://www.food.gov.uk/news/newsarchive/2011/jul/ecoliadvicehttp://en.wikipedia.org/wiki/Cruditéshttp://www.bloomberg.com/news/2011-07-01/crudites-in-bordeaux-bring-e-coli-sleuths-closer-to-diarrhea-bug-source.html

E. coli outbreak: EU withdraws Egyptian seeds from the market and temporarily bans their import05.jul.11 via barfblogEuropean CommissionBrussels — The European Union is withdrawing from the market, and temporarily banning the import of, certain types of seeds from Egypt after Egyptian fenugreek seeds were linked to the E. coli outbreaks (O104 strain) in northern Germany and Bordeaux, France. The decision follows a European Food Safety Authority (EFSA) report, published earlier today, establishing a link between the outbreaks and seeds from Egypt.Health and Consumer Commissioner John Dalli said: “Tracing back the origins of the E. coli O104 contaminations in Germany and France has been a key priority for the EU from day one of the crisis. The report published today leads us to withdrawing of some Egyptian seeds from the EU market and to a temporary ban on imports of some seeds and beans originating from that country. The Commission will continue to monitor the situation very closely and will take additional measures if necessary”.The measuresIn particular, the decision provides that Members States have to ensure that all lots of fenugreek seeds imported from one Egyptian exporter between 2009 and 2011 are withdrawn from the market, sampled and destroyed. Also, the decision provides that imports of Egyptian seeds and beans for sprouting1 are suspended until October 31.The measures, which are applicable immediately, were supported earlier today by the Member States in the Standing Committee on the Food Chain and Animal Health (SCoFCAH) following a Commission proposal on the issue. They will be reassessed regularly on the basis of guarantees offered by Egypt, results of laboratory testing and controls carried out by the Member States.EFSA’s reportThe EFSA report establishes that one lot of fenugreek seeds imported from one Egyptian exporter is the most likely common link between the two outbreaks. The report does not exclude that other lots may be implicated.EFSA also notes that –given the severity of the outbreaks and the absence of information on the means of contamination– it is appropriate to consider all lots of fenugreek seeds from the identified Egyptian exporter, and for the period 2009-2011, as suspect. In addition, the report notes that the contamination probably occurred before the seeds left the importer. The production or distribution process apparently allowed contamination with faecal material of human and/or animal origin. Where exactly this contamination occurred is still unknown, the report notes.BackgroundThe EU imports seeds for sprouting mainly from India and China. In 2010, the EU imported from Egypt about 49,000 tons of the types of seeds affected by today’s decision (please see endnote). Their total value was over 56 million euros.The German authorities first notified the Commission’s services of an E. coli outbreak on May 22. All of the Commission’s networks have been fully operational since then. For instance, the Rapid Alert System for Food and Feed and the Early Warning and Response System ensure rapid distribution of information throughout the EU.On June 5, a group of EU experts went to Germany to provide assistance with the epidemiology and with verifying results and contributed to the investigations to identify the source of contamination. On June 10 and 11, the German authorities confirmed, through epidemiology and laboratory testing, that the specific E. coli strain (O104), which is responsible for the outbreak, was detected in sprouts from one farm close to the city of Hamburg.On
June 23, France notified that people in the Bordeaux area got infected by E. coli after consuming bean sprouts. Laboratory tests that followed confirmed that it was the O104 strain. Today’s EFSA report establishes a link between Egyptian seeds and the outbreaks in Germany and France.The E. coli (O104) outbreak is responsible for 48 deaths in Germany and one in Sweden. The total number of cases reported in the EU, Norway and Switzerland is 4,178.For more information, please visit:

The latest news from the European Centre for Disease Prevention and Control, the EU’s CDC, suggests that the massive outbreak of E. coli O104 is declining. The number of new cases being discovered has fallen, and the most recent onset of illness among confirmed cases was June 27. The toll is now 752 cases of hemolytic uremic syndrome and an additional 3,016 cases of illness in 13 countries, for a total of 3,768 illnesses including 44 deaths. (The EU adjusted that total to remove 161 cases that were suspected but not lab-confirmed. It also did not include the five confirmed cases, one suspect case and one suspect death in the United States.)

But a simultaneous report from the European Food Safety Authority (EFSA) reveals that, despite the epidemic curve’s trending down, the outbreak can’t be considered over. The ultimate source — the contaminated seeds from which salad sprouts were grown — has been so widely distributed that no one really knows where they have gone or for how long they might remain for sale. One prediction, based on the probable package labeling, is that they could remain on shelves for 3 more years.

The technical report from EFSA is a stunning snapshot of the complexity of global food production. Here’s what the agency found:….

*A reader questions the links between #organic farming and the outbreak. Here’s some evidence

Egypt is free to export seeds to the European Union for the first time in eight months after the expiry in late March of a blanket ban on the activity.

Europe banned imports of some seeds and beans from Egypt in July 2011. The move came after food safety investigators said a single shipment of Egyptian fenugreek seeds was the most probable source of a toxic E. coli epidemic which killed 49 people in northern Europe.

David Tribe’s research career in academia and industry has covered molecular genetics, biochemistry, microbial evolution and biotechnology. He has over 60 publications and patents. Dr. Tribe's recent activities focus on agricultural policy and food risk management. He teaches graduate programs in food science and risk management as a Senior Lecturer in the Department of Agriculture and Food Systems, University of Melbourne.

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3 comments

The thing about these issues is that they appear to be new and extra dangerous, when in fact the opposite must be true.
That is, outbreaks of foodborne disease must have been rampant in years past, before we had dedicated government programs to chase them down and deal with them. And before we had more advanced means of preventing food-borne disease – HAACP, gene detection, etc.
When the US was mostly agrarian — something only recently beyond living memory — sickness must have been rampant. And far more deadly, without access to antibiotics, dialysis, etc.
One might argue that the outbreaks would be smaller, due to smaller operations dominating food production. Some actually believe this means ‘giant food processing facilities’ and ‘lots of food miles’ are at fault. Even when it’s most likely that all these smaller operations actually sickened and killed more persons in the past than today, and that the sickness and death rates were not tallied by public epidemiologists.

It is very unscientific to accuse Egyptian fenugreek seeds (after rushed and unscientific accusation of Spanish vegetables then German bean sprouts) because:
1- No scietific evidence that E. coli may persist on dry seeds for over 2 years
2- Non of the cases since the start of the outbreak reported eating sprouts of Egyptian fenugreek seeds for about 2 month
3- No single case of EHEC bloody diarrhoea or HUS-EHEC related cases was diagnosed in Egypt during this period
4- No eveidence that E. coli O104:H4 isolated from dry Egyptian seeds
5- Even if this organism could be identified on sprouts of Egyptian fenugreek seeds later, No one can exclude the possiblity of contammination during cultivation in any other place
6- Is it common practice in EU countries to import food stuff without testing them for possible bacterial contammination??
It is very obvious that the health authorties in many European countries (specially Germany) had many pitfalls in their epidemiologic work during investigating this outbreak, but making accusations on no scientif evidence is another kind of mistakes,,,
Dr. Aly Abedl-Moula, Epidemiologist

This added to the post
Influence of Lupin (Lupinus luteus L. cv. 4492 and Lupinus angustifolius L. var. zapaton) and Fenugreek (Trigonella foenum-graecum L.) Germination on Microbial Population and
Biogenic Amines
CRISTINA MARTIÄNEZ-VILLALUENGA, PIOTR GULEWICZ, ANTONIO PEÄ REZ, JUANA FRIÄAS, AND CONCEPCIOÄ N VIDAL-VALVERDE
J. Agric. Food Chem. 2006, 54, 7391−7398
Total coliform counts present in fenugreek seeds corresponded to ~ 4 log cfu/g, and germination led to a gradual increase of ~3 log cycles after 5 days to a maximum level of ~7.9 log cfu/g. However, coliform numbers were maintained between the third and fourth days of germination. Fecal coliform contamination of raw seeds corresponded to 3.6 log cfu/g of seeds. Fecal coliforms presented an upward trend to 2 log cycles after 3 days of germination to maximum counts of ~ 6 log cfu/ g. The amount of fecal Streptococci present in raw seeds was below 2 log cfu/g, and no changes were observed during germination.
Results obtained for raw seeds before sprouting correspond to those recorded by other authors for different kinds of seeds (27-30). Microbiological analyses have shown that alfalfa and mungbean seeds routinely contained high numbers of microbial flora (10^2-10^6 cfu/g), including coliforms (104 cfu/g) and fecal coliforms (10^2-10^3cfu/g), and that these organisms appeared to be part of the normal seed flora (4). Seeds of different plants differ in the microbial population, and these differences can be caused by the different compositions of the seed coat and different cultivation and storage conditions (28), although no
microbiological data have been published in lupin and fenugreek seeds.
The small amount of bacteria present in raw seeds can immediately grow during sprouting, because germination seems to provide ideal conditions for bacterial growth (28). Within the first two sprouting days microbial populations increased approximately 2 log cycles in rice seeds (28), 3 log cycles on alfalfa seeds and mungbeans (10, 31), and 4 log cycles in kidney beans (30). Several factors have been identified that contribute
to the rapid proliferation of bacteria on sprouts…

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